Duane Winter Memorial Scholarship Application Form

Tell us about yourself

First Name
Middle Name
Last Name
e-mail
Address 1
Address 2
CITY
POSTAL CODE
Phone Number
date of birth (yyyy-mm-dd)
university/ college
program
year of study
date of application (yyyy-mm-dd)

upload Documents & signature

Documents
Click or drag a file to this area to upload.
Signature
Click or drag a file to this area to upload.

Documents To Be Included
Please ensure the following are attached to your completed application:

Download the Duane Winter Scholarship Budget Review Worksheet, fill it out, and upload it with all other documents. Please open the budget sheet via Google Sheets or with your desktop application.

Please check all boxes and ensure all required documents have been uploaded *

Evidence of participation in HAAC-related work would be considered an asset.

Recipients may be asked to attend the HAAC event to acknowledge receipt of the Scholarship.
* INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. *